title: The effect of prophylactic treatment with Shohl's solution in children with cystinuria.
abstract: OBJECTIVE
  To investigate the effect of prophylactic treatment with Shohl's solution on the rates of stone recurrence in paediatric patients with cystinuria.
  
  
  METHODS
  Between June 2007 and October 2011, 185 patients aged 16 years and younger whose stones had been completely removed by percutaneous nephrolithotomy (PCNL) were assessed for metabolic risk factors. Seventeen (9%) patients with positive cyanide-nitroprusside tests (CNT) and cystine stones enrolled in this study, and a Shohl's solution was used for alkalinisation. The patients were followed up for a mean period of two years for stone recurrence.
  
  
  RESULTS
  Of the patients, 10 (59%) were male, and 7 (41%) were female (p = 0.13). Twelve patients (70.5%) continued to receive medical prophylaxis regularly, whereas 5 (29.5%) patients did not. The mean pre-treatment and post-treatment urinary pH values were 5.8 ± 0.5 (5-7) and 7.5 ± 0.4 (6.5-8), respectively (p < 0.001). The pre-treatment and post-treatment specific gravities of the urine were 1021.5 ± 5.4 (1010-1030) and 1006 ± 2.3 (1004-1015), respectively (p < 0.001). The rates of recurrence were 16.6% among those who continued prophylaxis and 100% among those who did not receive prophylaxis (p = 0.001). The most common combination of metabolic anomalies was cystinuria and hypocitraturia (p < 0.001).
  
  
  CONCLUSIONS
  This study demonstrated that detailed clinical and laboratory evaluations should be performed for all children with cystine stone disease, and, appropriate prophylactic treatment should be recommended to prevent the reformation of stones.
authors.affiliation: Department of Urology, Faculty of Medicine, University of Çukurova, Balcali, 01330 Adana, Turkey. Electronic address: volkanizol@yahoo.com.
authors.forename: Volkan
authors.initials: V
authors.lastname: Izol
authors.forename: Ibrahim Atilla
authors.initials: IA
authors.lastname: Aridogan
authors.forename: Onur
authors.initials: O
authors.lastname: Karsli
authors.forename: Mutlu
authors.initials: M
authors.lastname: Deger
authors.forename: Nihat
authors.initials: N
authors.lastname: Satar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019343:Citric Acid / Q000627:therapeutic use*; D003555:Cystinuria / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D009403:Nephrostomy, Percutaneous; D019357:Potassium Citrate / Q000627:therapeutic use*; D012307:Risk Factors; D055502:Secondary Prevention; D012996:Solutions / Q000627:therapeutic use; D052878:Urolithiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D012996:Solutions; D019343:Citric Acid; D019357:Potassium Citrate
keywords: Children; Cystinuria; Recurrence; Shohl's solution; Urolithiasis